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RVOT VT or Vasovagal Syncope?
by 416340, Sep 17, 2007 11:08AM
I'm a 24 year old female who has been diagnosed with RVOT PVC’s with LBBB and inferiorly directed axis (one holter monitor shows over 28,000 PVC’s and another holter shows 35,000 PVC's). I do not feel those constant PVC’s however, I do have episodes where I get extremely dizzy, weak and have chest pain and palpitations. I have passed out a few times. These episodes use to happen once a month, but since February they began to happen about 3-4 times a week. These episodes happen when standing, sitting and even while lying down. Twice, I have woken up from sleep violently gasping for air. My cardiologist first said my episodes were due to RVOT VT, but now believes that these episodes are not related to the PVC’s and believes that they are vasovagal episodes. I had a tilt table test preformed, but it was negative, likely because I am now on Sotalol to help suppress the PVC’s and reduce my symptoms.
I do have a brother that passed away suddenly when only a few months of age, so a cardiac MRI is being booked to rule out (ARVC). Do you feel that these episodes could possibly be due to vasovagal sycope, or should I be trying to push my cardiologist for a more firm diagnosis and analysis? Also, on one holter, 60 escape beats were found. Are these of any signifance?
I was considering getting ablation done to reduce the PVC’s and frequency/severity of the episodes because I have been having some side effects of the medication and do not what to take beta blockers for the rest of my life. But I also hesitate to do the ablation if the PVC’s are not the cause of my episodes.
Any advise or suggestions would be great.
I do have a brother that passed away suddenly when only a few months of age, so a cardiac MRI is being booked to rule out (ARVC). Do you feel that these episodes could possibly be due to vasovagal sycope, or should I be trying to push my cardiologist for a more firm diagnosis and analysis? Also, on one holter, 60 escape beats were found. Are these of any signifance?
I was considering getting ablation done to reduce the PVC’s and frequency/severity of the episodes because I have been having some side effects of the medication and do not what to take beta blockers for the rest of my life. But I also hesitate to do the ablation if the PVC’s are not the cause of my episodes.
Any advise or suggestions would be great.
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Good luck!
connie
I just happen to find this as i was surfing the web on my free time...I do hope this message reaches you in time.
I am a clinical electrophysiologist and we come across similar stories in patients. I have couple of patients with similar history as yours and they have been either diagnosed with ARVD and are being treated with sotalol and ICD or have had an ablation for RVOT VT. I think you should be evaluated by a clinical electrophysiologist who has experience with VT and ARVC. If you have ARVC it is a difficult disease entity to treat.
Please go to Heart Rhythm Society web site to find an electrophysiologist near where you live. www.HRSonline.org. If you need any recommendations, please post a comment back and i will refer you to someone experienced.